| NPI | 1962896548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY BEAUREGARD President & CEO 860-291-1340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 702) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2016-06-08 |